Search form

Search form

Hospitals and medical systems are increasingly merging with or buying competitors, potentially driving up health care prices as they gain negotiating power over payers, experts say. "The rhetoric is all about efficiency. The reality is all about higher prices," said AHIP President and CEO Karen Ignagni. Some 20% of U.S. hospitals are likely to seek mergers within the next five to seven years, Booz & Company analysts say.

Related Summaries

EmblemHealth operates in Connecticut, New Jersey and all of New York, and two-thirds of payments are value-based, says CEO Karen Ignagni. "Accountable care organizations are definitely in scope for us," and the contracts involve shared risk, Ignagni said. The company will be seeking more Medicare Advantage opportunities as well as risk-sharing agreements with health care providers, Ignagni said.

The federal government will run Idaho's health insurance exchange next year, but state officials expect to take over in 2015. The federal site will also include features allowing residents to sign up for Medicaid in compliance with Idaho's eligibility rules.

The Affordable Care Act makes preventive services free to Medicare beneficiaries, but cuts to Medicare Advantage plans jeopardize some potential gains in ways that are not yet fully understood, says AHIP President and CEO Karen Ignagni. "Because the vast majority of the ACA's cuts to the Medicare Advantage program have not yet taken effect, beneficiaries have not yet felt their full impact," Ignagni said in a statement.

Conversations about health care are shifting to reining in the cost of care, said AHIP president and CEO Karen Ignagni. "When we look at health reform we look at it through the prism of affordability and disruption, [which means] making sure that care is affordable a year from now and making sure that employers who are providing coverage and individuals who are buying are not disrupted," Ignagni said.